NU371 Week 8 PrepU: Sexually Transmitted Infections
(STIs) Fall 2023 with complete solution
A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain
on urination, erythema, and an odorless, thick, acid vaginal discharge. She
denies sexual activity during the last 6 months. Her records show that she has
diabetes mellitus and uses oral contraceptives. Which category of antimicrobial
medication is most likely to clear her symptoms?
ciprofloxacin, a fluoroquinolone antibiotic
Clotrimazole, an antifungal agent.
Penicillin V potassium, a broad-spectrum antibiotic
Tenofovir, an antiviral agent
Clotrimazole, an antifungal agent.
o The character of the discharge and the lack of recent sexual activity suggest infection
with Candida, which can exist asymptomatically and flare up only if conditions, such as
an imbalance in normal vaginal flora resulting from antibiotic treatment, diabetes, or oral
contraceptive use, enable the fungus to proliferate. Candidiasis responds well to
treatment with azole antifungal agents.
Pelvic infection is most commonly caused by:
induced abortion (medical abortion).
insertion of intrauterine device.
hysteroscopy.
sexual transmission.
sexual transmission.
o Pelvic infection is most commonly caused by sexual transmission but can also occur
with invasive procedures such as endometrial biopsy, induced abortion (medical
abortion), hysteroscopy, or insertion of an intrauterine device.
A community health nurse is conducting an educational session at a local
community center on sexually transmitted infections (STIs). The nurse considers
the session successful when participants identify which statement as correct?
"At least antibiotics will cure a sexually transmitted infection."
"Gonorrhea and syphilis are infections seen only in men."
"Human papillomavirus is the cause of essentially all cases of cervical cancer."
"STIs can't be transmitted through oral sexual intercourse."
"Human papillomavirus is the cause of essentially all cases of cervical cancer."
o Clinical studies have confirmed that HPV is the cause of essentially all cases of
cervical cancer, which is the fourth most common cancer in women in the United
States. Up to 95% of cervical squamous cell carcinomas and nearly all preinvasive
cervical neoplasms are caused by the HPV. Antibiotics will only cure those STIs caused
by bacterial infections. A viral STI infection is a lifetime infection. Gonorrhea and
syphilis affect both men and women. Sexually transmitted infections are infections of
the reproductive tract caused by microorganisms transmitted through oral sexual
intercourse.
,For a woman, what is the most serious long-term outcome of an infection
resulting from exposure to the N. gonorrhoeae bacteria?
Dysuria
Sterility
Postcoital bleeding
Bartholin gland abscesses
Sterility
o There may be infections of the uterus and development of acute or chronic infection
of the fallopian tubes (i.e., salpingitis), with ultimate scarring and sterility. The other
options are less serious in nature.
The nurse explains to a client diagnosed with trichomoniasis that the disease is
caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse
say is a factor that triggers growth of trichomoniasis?
spontaneous abortion (miscarriage)
trauma to the bladder
being postmenopausal
irritation of vaginal walls
irritation of vaginal walls
o Factors that trigger growth of trichomoniasis include irritation of vaginal walls,
pregnancy, sexual activity, trauma to the vaginal walls, systemic illness, menstruation,
and emotional upsets.
Which client is at highest risk of developing trichomoniasis?
A client newly diagnosed with diabetes mellitus type 2
A client who is sexually active
A client who completed a 10-day course of antibiotic therapy for a urinary tract
infection
A client who is taking 10 different medications
A client who is sexually active
o A reported risk factor for trichomoniasis is sexual activity, as the parasite can be
transmitted to sexual partners. The other symptoms are not listed as predisposing risk
factors for this condition.
A client has been diagnosed with a chlamydial infection. Select the
pharmacologic treatment of choice.
Azithromycin
Bactrim
Acyclovir
Ceclor
Azithromycin
o The CDC recommends the use of azithromycin or doxycycline in the treatment of
chlamydial infection; penicillin is ineffective. Azithromycin or amoxicillin is the preferred
choice in pregnancy.
In assessing a client, the nurse notes a grayish discharge from the vaginal area
accompanied by a foul odor. What is the nurse’s best action?
Applying an antifungal cream
Asking about other symptoms
Encouraging better hygiene
, Flushing the area with an antibiotic wash
Asking about other symptoms
o Bacterial vaginosis is accompanied by a grayish white discharge with a foul odor. The
nurse should ask about other symptoms (such as redness, itching, and burning) before
implementing any interventions. Antibiotic “washing” is not an acceptable intervention.
Antifungal creams are not used for bacteria.
A client is experiencing situational low self-esteem about acquiring a sexually
transmitted infection. Which nursing intervention may help foster the client’s self-
esteem?
Affirm the client’s good judgment in seeking treatment.
Explain the cause of the sexually transmitted infection (STI).
Schedule an appointment for follow-up care.
Provide the client with a telephone number for obtaining accurate information.
Affirm the client’s good judgment in seeking treatment.
o The nurse should affirm the client’s good judgment in seeking treatment.
Acknowledging positive action helps increase the client’s self-esteem. Explaining the
cause of the STI and how to avoid potential consequences or complications dispels
inaccurate beliefs and misconceptions and helps the client to acquire realistic
information. It does not help the client’s self-esteem to be positive. Providing the client
with a telephone number for obtaining objective and authoritative information helps the
client to ask more questions about an STI and its treatment. Medical follow-up promotes
compliance with therapeutic regimen and does not help the client’s self-esteem to be
positive.
A nurse is caring for a client in the clinic. Which sign or symptom may indicate
that the client has gonorrhea?
dry, hacking cough
painless chancre
burning on urination
diffuse skin rash
burning on urination
o Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry,
hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may
indicate secondary stage syphilis. A painless chancre is the hallmark of primary
syphilis. It appears wherever the organisms enter the body, such as on the genitalia,
anus, or lips.
In which group is it most important for the client to understand the importance of
an annual Papanicolaou test?
Clients with a history of recurrent candidiasis
Clients with a pregnancy before age 20
Clients infected with the human papillomavirus (HPV)
Clients with a long history of hormonal contraceptive use
Clients infected with the human papillomavirus (HPV)
o HPV causes genital warts, which are associated with an increased incidence of
cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of hormonal
contraceptives don’t increase the risk of cervical cancer.
Which event is associated with the primary stage of syphilis?
(STIs) Fall 2023 with complete solution
A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain
on urination, erythema, and an odorless, thick, acid vaginal discharge. She
denies sexual activity during the last 6 months. Her records show that she has
diabetes mellitus and uses oral contraceptives. Which category of antimicrobial
medication is most likely to clear her symptoms?
ciprofloxacin, a fluoroquinolone antibiotic
Clotrimazole, an antifungal agent.
Penicillin V potassium, a broad-spectrum antibiotic
Tenofovir, an antiviral agent
Clotrimazole, an antifungal agent.
o The character of the discharge and the lack of recent sexual activity suggest infection
with Candida, which can exist asymptomatically and flare up only if conditions, such as
an imbalance in normal vaginal flora resulting from antibiotic treatment, diabetes, or oral
contraceptive use, enable the fungus to proliferate. Candidiasis responds well to
treatment with azole antifungal agents.
Pelvic infection is most commonly caused by:
induced abortion (medical abortion).
insertion of intrauterine device.
hysteroscopy.
sexual transmission.
sexual transmission.
o Pelvic infection is most commonly caused by sexual transmission but can also occur
with invasive procedures such as endometrial biopsy, induced abortion (medical
abortion), hysteroscopy, or insertion of an intrauterine device.
A community health nurse is conducting an educational session at a local
community center on sexually transmitted infections (STIs). The nurse considers
the session successful when participants identify which statement as correct?
"At least antibiotics will cure a sexually transmitted infection."
"Gonorrhea and syphilis are infections seen only in men."
"Human papillomavirus is the cause of essentially all cases of cervical cancer."
"STIs can't be transmitted through oral sexual intercourse."
"Human papillomavirus is the cause of essentially all cases of cervical cancer."
o Clinical studies have confirmed that HPV is the cause of essentially all cases of
cervical cancer, which is the fourth most common cancer in women in the United
States. Up to 95% of cervical squamous cell carcinomas and nearly all preinvasive
cervical neoplasms are caused by the HPV. Antibiotics will only cure those STIs caused
by bacterial infections. A viral STI infection is a lifetime infection. Gonorrhea and
syphilis affect both men and women. Sexually transmitted infections are infections of
the reproductive tract caused by microorganisms transmitted through oral sexual
intercourse.
,For a woman, what is the most serious long-term outcome of an infection
resulting from exposure to the N. gonorrhoeae bacteria?
Dysuria
Sterility
Postcoital bleeding
Bartholin gland abscesses
Sterility
o There may be infections of the uterus and development of acute or chronic infection
of the fallopian tubes (i.e., salpingitis), with ultimate scarring and sterility. The other
options are less serious in nature.
The nurse explains to a client diagnosed with trichomoniasis that the disease is
caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse
say is a factor that triggers growth of trichomoniasis?
spontaneous abortion (miscarriage)
trauma to the bladder
being postmenopausal
irritation of vaginal walls
irritation of vaginal walls
o Factors that trigger growth of trichomoniasis include irritation of vaginal walls,
pregnancy, sexual activity, trauma to the vaginal walls, systemic illness, menstruation,
and emotional upsets.
Which client is at highest risk of developing trichomoniasis?
A client newly diagnosed with diabetes mellitus type 2
A client who is sexually active
A client who completed a 10-day course of antibiotic therapy for a urinary tract
infection
A client who is taking 10 different medications
A client who is sexually active
o A reported risk factor for trichomoniasis is sexual activity, as the parasite can be
transmitted to sexual partners. The other symptoms are not listed as predisposing risk
factors for this condition.
A client has been diagnosed with a chlamydial infection. Select the
pharmacologic treatment of choice.
Azithromycin
Bactrim
Acyclovir
Ceclor
Azithromycin
o The CDC recommends the use of azithromycin or doxycycline in the treatment of
chlamydial infection; penicillin is ineffective. Azithromycin or amoxicillin is the preferred
choice in pregnancy.
In assessing a client, the nurse notes a grayish discharge from the vaginal area
accompanied by a foul odor. What is the nurse’s best action?
Applying an antifungal cream
Asking about other symptoms
Encouraging better hygiene
, Flushing the area with an antibiotic wash
Asking about other symptoms
o Bacterial vaginosis is accompanied by a grayish white discharge with a foul odor. The
nurse should ask about other symptoms (such as redness, itching, and burning) before
implementing any interventions. Antibiotic “washing” is not an acceptable intervention.
Antifungal creams are not used for bacteria.
A client is experiencing situational low self-esteem about acquiring a sexually
transmitted infection. Which nursing intervention may help foster the client’s self-
esteem?
Affirm the client’s good judgment in seeking treatment.
Explain the cause of the sexually transmitted infection (STI).
Schedule an appointment for follow-up care.
Provide the client with a telephone number for obtaining accurate information.
Affirm the client’s good judgment in seeking treatment.
o The nurse should affirm the client’s good judgment in seeking treatment.
Acknowledging positive action helps increase the client’s self-esteem. Explaining the
cause of the STI and how to avoid potential consequences or complications dispels
inaccurate beliefs and misconceptions and helps the client to acquire realistic
information. It does not help the client’s self-esteem to be positive. Providing the client
with a telephone number for obtaining objective and authoritative information helps the
client to ask more questions about an STI and its treatment. Medical follow-up promotes
compliance with therapeutic regimen and does not help the client’s self-esteem to be
positive.
A nurse is caring for a client in the clinic. Which sign or symptom may indicate
that the client has gonorrhea?
dry, hacking cough
painless chancre
burning on urination
diffuse skin rash
burning on urination
o Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry,
hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may
indicate secondary stage syphilis. A painless chancre is the hallmark of primary
syphilis. It appears wherever the organisms enter the body, such as on the genitalia,
anus, or lips.
In which group is it most important for the client to understand the importance of
an annual Papanicolaou test?
Clients with a history of recurrent candidiasis
Clients with a pregnancy before age 20
Clients infected with the human papillomavirus (HPV)
Clients with a long history of hormonal contraceptive use
Clients infected with the human papillomavirus (HPV)
o HPV causes genital warts, which are associated with an increased incidence of
cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of hormonal
contraceptives don’t increase the risk of cervical cancer.
Which event is associated with the primary stage of syphilis?
